Hayashi M, Handa Y, Kobayashi H, Kawano H, Nozaki J, Hirose S
Department of Neurosurgery, Fukui Medical School, Japan.
Zentralbl Neurochir. 1988;49(2):101-8.
The prognosis of intraventricular hemorrhage (IVH) due to hemorrhagic cerebrovascular disease has been regarded as unfavorable. The authors studied factors affecting the prognosis in 55 patients with IVH due to hypertensive thalamic and putaminal hemorrhages. The mortality rate in this study was 38%, a poorer rate than that in patients without IVH (18%). As for morbidity, 50% of the survivors (31% of all patients) with IVH had nor or moderate disability, but the other 50% had severe disability or were in a persistent vegetative state. On the other hand, there was no or moderate disability in 55%, and severe disability or a persistent vegetative state in 27% of the patients without IVH. Patients with intracerebral or intraventricular hematoma volumes greater than 25 ml, Glasgow Coma Scales of less than nine, intracranial pressures above 30 mm Hg, and ventriculocranial ratios over 0.22 had poor prognoses. These results suggest that greater volumes of intracerebral or intraventricular hematoma and the presence of acute hydrocephalus are of great significance when considering the outcomes of IVH cases.
出血性脑血管病所致脑室内出血(IVH)的预后一直被认为不佳。作者研究了55例因高血压丘脑和基底节出血导致IVH患者的预后影响因素。本研究中的死亡率为38%,比无IVH患者的死亡率(18%)更高。至于发病率,IVH幸存者中有50%(占所有患者的31%)无残疾或有中度残疾,但另外50%有严重残疾或处于持续性植物状态。另一方面,无IVH患者中有55%无残疾或有中度残疾,27%有严重残疾或处于持续性植物状态。脑内或脑室内血肿体积大于25 ml、格拉斯哥昏迷量表评分低于9分、颅内压高于30 mmHg以及脑室颅比超过0.22的患者预后较差。这些结果表明,在考虑IVH病例的预后时,更大体积的脑内或脑室内血肿以及急性脑积水的存在具有重要意义。